| My OCD. This is how I refer to this
"Disorder." I put it in quotes because I have a
very hard time accepting that it is a condition that I did
not bring on myself. I mean, I always thought that my
obsessiveness was me -- brought on by me. But I guess it
doesn't matter whether it is a mental condition, or a way
of thinking which became a habit. What is important to me,
is that I take steps to change.
By steps, I mean risks. I learned of the concept of
risk taking for treating OCD in my therapy sessions with
Dr. Steven Phillipson, a clinical psychologist at the
Institute for Behavior Therapy, in New York City. The key
element of the treatment is learning to live with
uncertainty. It is taking the risk of not ruminating
(problem solving) about things that I am afraid might
happen. If you will notice, most obsessions concern things
that we are not sure about. For example, I can obsess
endlessly about people that I think may not like me. The
subjects of my obsessions are usually people I don't know
well but that I come in contact with on a regular basis
(e.g. neighbors), so I could never really know whether
they do or do not like me. With therapy, I learned to say
"Yes, maybe the neighbors don't like me, but I'm not
going to take the risk of ruminating about it, and I will
not attend to any other thoughts related to these
people."
To not actively attend to a thought (called a
"spike" in therapy), is another risk. We usually
pay attention to thoughts that we think are worth our
time. The more we pay attention to a thought (by
ruminating), the more our brain becomes sensitized to it.
That is, our brain gets the impression that the thought
must be very important; moreover, when we don't attend to
the thought, our brain will try to warn us by way of
anxiety.
Accepting anxiety is a critical part of treatment. The
anxiety one feels when not doing a ritual (my ritual is to
ruminate), can be dreadful. But it gets easier with time
and practice. By not ruminating, or giving the thought any
importance, the brain will start getting the message that
this thought is not so important, and therefore will not
try to warn us. One of the first things Dr. Phillipson and
I tackled was my "checking" with people. For
example, I would ask my family to describe their feelings
about the neighbors. This was really my only compulsive
overt behavior. (Let me point out that I realize that many
people might have the same concerns, e.g., people not
liking them, but most people would not spend hours and
hours every day going over the same thought. Also, most
people would not feel terribly anxious when they could not
ruminate or do a "check."). I learned to take
the risk and not check things out with my family.
Another technique I use is what Dr. Phillipson calls
the "flagging" technique: any thought related to
people not liking me is flagged as an OCD spike and
therefore is not to be attended to. That is, instead of
actually saying that I will take the risk ..., I don't say
anything at all. I just let the thoughts come and go.
By all means, the treatment is not easy. It requires a
tremendous amount of courage. Obsessing was something I
did practically all of my life ( I was 5 when it began; I
am now 27). Ruminating felt right. I always thought I had
to do it; that it was my duty. To not ruminate was the
scariest thing I ever did. Dr. Phillipson helped me to
conjure up courage by sharing with me some of his views on
life. For example, he says that we don't have to do
anything; we choose to do things. Concepts such as these
helped me to be less rigid and to allow myself to take
risks.
Since this treatment is based on changing our behavior
(in my case, not ruminating), it is crucial to do the
homework assignments. This may require a lot of
self-discipline (and again, courage). Most of my homework
assignments entailed purposely bringing on frightening
thoughts and not ruminating about them. It helps to set a
specific time and place, so that it almost becomes a habit
when it's that time, and you're at that place. For
example, I do my homework on the train on the way to work
every morning.
I've been going to group and individual therapy with
Dr. Phillipson for almost 3 years. I still struggle, but
not nearly as hard as before. The urge to ruminate is not
so great anymore. I used to ruminate about 70% of the
time; now I ruminate about 10% of the time. when I get
thoughts that might be OCD related, I try to let them come
and go, along with the mild anxiety. I may never be
"cured," but I feel confident that I will be
able to cope. I now experience feelings other than
anxiety, and I get concerned about issues other than
people not liking me. In other words, I feel so much more
alive.
|
